Jenny Holaday remembers having friends tell her that once she had a baby, she’d never get on a trampoline again. At the time, she basically shrugged them off.
“I was like, ‘Okay, whatever.’ Well, they were not wrong.”
After Jenny’s daughter Finley was born in 2018, not only was the new mom not jumping on a trampoline, but she was thinking twice about nearly every physical activity.
“I couldn’t run without peeing,” Jenny stated, frankly. “I couldn’t even laugh without leaking.”
Like many women postpartum, Jenny made adjustments to her daily activities to deal with the incontinence issues she was having. But at her six-week postpartum checkup, her obstetrician surprised her by asking if she was having this problem.
“She was so nonchalant about it,” Jenny recalled. “She said physical therapy would help, that I did not, at 26 years old, have to have this problem, and it was no big deal to simply make a referral.
Jenny started her physical therapy journey at Therapeutic Associates Bethany where she quickly overcame her anxiety about PT treatment for the pelvic floor. She progressed through several sessions, her optimism rising, but unfortunately her dedication to her healing fizzled when other obligations in life overwhelmed her time.
Her physical therapy exposure had been enough, however, that when she became pregnant again a couple years later and began to experience pubic symphysis pain, she reached out to Therapeutic Associates.
“I knew what I needed and because I’d been referred before, I knew Therapeutic Associates had pelvic floor specialists. I asked for a clinic close to me, which is how I connected with Anne at Sherwood.”
Before her first appointment, unfortunately, Jenny lost the baby. But instead of canceling, she rescheduled.
“I was still having issues with urinary incontinence when exercising and knew I could use the help anyway. I also knew I was going to try for another baby and this would all continue to be a problem. After everything with my miscarriage settled, I started working with Anne.”
Knowing that Jenny had struggled with some pelvic floor issues even during and after her first pregnancy, Anne Jeffery, practice manager and PT at Therapeutic Associates Sherwood Physical Therapy, said she felt that it was a great time to help her build strength and get ready for a third pregnancy.
“I wish I could see more women even before they start trying for pregnancy,” Anne emphasized as she reflected on the joy of watching Jenny go through the whole journey. A lot of women, she explained, don’t seek the care of a physical therapist until later in their pregnancy or postpartum. “There’s a whole preventative aspect of checking in on how your pelvic floor muscles are firing, and determining what we can do to be proactive about strengthening and doing coordination training for those muscles and getting ready for pregnancy.”
In Pursuit of Pelvic Health
Jenny was inspired to prepare for her next pregnancy, but she was also extremely motivated to be able to get back to a place where it was easy doing all the things she loves to do, things like hiking.
“If I went for a hike I had to wear a panty liner or a pad; I would need to be prepared and could not just do things like that spontaneously. Of course babies change that in every way, but I just wanted to be normal and not always concerned about peeing my pants.”
Jenny’s PT journey began with a thorough assessment — gauging where her weakness was and identifying what activities caused pain, which triggered her urgent need to pee and what would cause her to lose all confidence that she could hold her urine. Pelvic floor therapy can include an internal exam during assessment, but everyone’s story is different. Anne approached Jenny’s care with a personalized plan and developed a unique program specific to what her body had been through.
Through it all, Jenny said, she felt heard. If an exercise was painful for her, then Anne would alter it to make it comfortable. If she was short on time, then Anne would tell her how to maximize what time she did have.
“One of the things I really appreciated about Anne was how receptive she was to me saying I couldn’t do something because of my schedule,” Jenny said. Pelvic floor exercises, she explained, take a lot of mental focus, which makes some moves nearly impossible to do with a toddler nearby needing attention. “Anne was very understanding — she has a toddler at home, so she knows what that looks like.”
Prenatal Physical Therapy
After two months working with Anne, Jenny’s story took a turn. The pregnancy she’d been preparing and hoping for came to fruition.
As Jenny’s pregnancy progressed, Anne prescribed exercise that accounted for the weight and resistance of the growing baby.
“During pregnancy it can feel like you’re going backward, like your exercises are getting easier but are feeling harder,” Anne explained. “Pre-pregnancy or early in pregnancy we might have you using a 15-pound kettlebell or a heavy resistance band, but a few months down the road, now you have a bowling ball inside of you so you have resistance in a whole different way so we drop the weight or the band.”
In addition to helping her understand and strengthen her pelvic floor, physical therapy empowered Jenny to overcome pelvic pain during her pregnancy — pain that she, like many women, considered normal and did not realize PT could help. It also gave her an opportunity to really prepare for labor.
With her due date approaching, Jenny, along with her husband, spent time with Anne working on position training. With the help of a surface Electromyography biofeedback unit that measures muscle activation and relaxation, they were able to see which body positions allowed Jenny to relax her pelvic floor most thoroughly.
“It was empowering to know there are so many different ways you can labor, and to know what position would make it go faster and easier for me,” Jenny explained. Equipped with that understanding and knowledge, she only pushed eight times to bring her son James into the world. “It was a lot longer with my daughter!”
With a newborn baby and a busy toddler at home, Jenny’s life looks different than it did before kids, but thanks to her physical therapy journey, she said she feels like she’s living life normally now.
“I used to worry, ‘Can I chase after Finley? What if I have to run to catch her?’ I was always leaking and always worried about it,” Jenny reflected. “I just don’t have that concern anymore.”
Three weeks postpartum, Jenny snuggled James into a front pack and headed out on a family hike. She didn’t think about having to prepare for leaking or needing to stop during their adventure.
“It was very freeing, and at the end when I realized I had just done the whole hike without any issues … I felt so good about that. I think I emailed Anne the very next day!”
Jenny couldn’t wait to share the news and express her gratitude to Anne, whose help she describes as “literally life changing.” The smile on her face in the post-hike photo she included with the email says it all.
The joy and freedom that Jenny felt that day is something she said every woman should feel. No woman, she said, should feel like she can’t do certain things just because she had a baby.
“It should not be accepted that women just pee their pants after they have a baby,” Jenny said. “Not all women do, but lots do, and that should not be the norm.”
The risk of incontinence does increase with childbirth, Anne noted, but while it is common, she added, it is not normal.
“There are different reasons why this is more common after childbirth, but it is absolutely something physical therapy can help with,” Anne emphasized. “It is exciting to see that more and more women are learning about pelvic floor PT, and it is my mission to keep spreading the word so that we can help as many women as possible!”